Superficial peroneal nerve entrapment in ankle sprain in childhood and adolescence

Traumatic injuries of the ankle are the most common injuries in sports. Up to 40% of patients who have undergone inversion ankle sprain report residual symptoms. The primary purpose of the study is to evaluate the incidence of SPN entrapment as consequence of acute severe inversion ankle sprain in children and adolescents; the secondary is to report the diagnostic pathway and the results after surgical treatment. From 2000 to 2015 were reviewed to summarize patients under the age of 15 years treated for a first episode of severe inversion ankle sprain. Cases with persistent symptoms (more than 3 months) indicative for SPN neuropathy were then identified. Instrumental investigations were recovered and a pre-operative assessment of pain (VAS) was recorded. Patients were evaluated at minimum of 1-year post-operative follow-up. 981 acute ankle sprains have been evaluated. 122 were considered severe according to van Dijk criteria. 5 patients were considered affected by neuropathy of the SPN. All patients underwent surgery consisting in neurolysis and capsular retention and ligament reconstruction. At 25 months of follow-up AOFAS moved from 57.6 to 98.6. The study highlights a previously unreported condition of perineural fibrosis of the superficial peroneal nerve at the level of the ankle following first acute severe inversion ankle sprain in children

Ordered quantization and the Ehrenfest time scale

We propose a prescription to quantize classical monomials in terms of symmetric and ordered expansions of noncommuting operators of a bosonic theory. As a direct application of such quantization rules, we quantize a classically time evolved function O(q,p,t), and calculate its expectation value in coherent states. The result can be expressed in terms of the application of a classical operator that performs a Gaussian smoothing of the original function O evaluated at the center of the coherent state. This scheme produces a natural semiclassical expansion for the quantum expectation values at a short time scale. Moreover, since the classical Liouville evolution of a Gaussian probability density gives the same form for the classical statistical mean value, we can calculate the first-order correction in h entirely from the associated classical time evolved function. This allows us to write a general expression for the Ehrenfest time in terms of the departure of the centroid of the quantum distribution from the classical trajectory, provided we start with an initially coherent state for each subsystem. In order to illustrate this approach, we have calculated analytically the Ehrenfest time of a model with N-coupled nonlinear oscillators with nonlinearity of even order.681

The palaeo-bathymetry of base Aptian salt deposition on the northern Angolan rifted margin: constraints from flexural back-stripping and reverse post-break-up thermal subsidence modelling

International audienc

Structure of the ocean–continent transition, location of the continent–ocean boundary and magmatic type of the northern Angolan margin from integrated quantitative analysis of deep seismic reflection and gravity anomaly data

AbstractThe crustal structure and distribution of crustal types on the northern Angolan rifted continental margin have been the subject of much debate. Hyper-extended continental crust, oceanic crust and exhumed serpentinized mantle have all been proposed to underlie the Aptian salt and the underlying sag sequence. Quantitative analysis of deep seismic reflection and gravity anomaly data, together with reverse post-break-up subsidence modelling, have been used to investigate the ocean–continent transition structure, the location of the continent–ocean boundary, the crustal type and the palaeobathymetry of Aptian salt deposition. Gravity inversion methods (used to give the depth to the Moho and the crustal thickness), residual depth anomaly analysis (used to identify departures from oceanic bathymetry) and subsidence analysis have all shown that the distal Aptian salt is underlain by hyper-extended continental crust rather than exhumed mantle or oceanic crust. We propose that the Aptian salt was deposited c. 0.2 and 0.6 km below global sea-level and that the inner proximal salt subsided by post-rift (post-tectonic) thermal subsidence alone, whereas outer distal salt formation was synrift, prior to break-up, resulting in additional tectonic subsidence. Our analysis argues against Aptian salt deposition on the Angolan margin in a 2–3 km deep isolated ocean basin and supports salt deposition on hyper-extended continental crust formed by diachronous rifting migrating from east to west and culminating in the late Aptian.</jats:p

Massive facial edema and airway obstruction secondary to acute postoperative sialadenitis or "anesthesia mumps": a case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Worry about crime in Europe: A model-based small area estimation from the European Social Survey

© The Author(s) 2019. Worry about crime is known to be higher in some European regions than others. However, cross-national surveys, which are the main source of information to map worry about crime across Europe, are designed to be representative of large areas (countries), and regions often suffer from small and unrepresentative sample sizes. This research produces reliable model-based small area estimates of worry about crime at regional level from European Social Survey data, in order to map the phenomenon and examine its macro-level predictors. Model-based small area estimation techniques borrow strength across areas to produce reliable estimates of parameters of interest. Estimates of worry about crime are higher in most South and East European regions, in contrast to Northern and Central Europe

Phase I study of intermittent and chronomodulated oral therapy with capecitabine in patients with advanced and/or metastatic cancer

BACKGROUND: The combination of capecitabine and gemcitabine at Fixed Dose Rate (FDR) has been demonstrated to be well tolerated, with apparent efficacy in patients with advanced cancers. FDR gemcitabine infusion leads to enhanced intracellular accumulation of drug and possible augmented clinical effect. The goals of this phase I study were to determine the maximum-tolerated dose (MTD) of chronomodulated capecitabine in patients with advanced cancer and to describe the dose-limiting toxicities (DLT), the safety profile of this way of administration. METHODS: Patients with advanced solid tumours who had failed to response to standard therapy or for whom no standard therapy was available were elegible for this study. Capecitabine was administered orally according to following schedule: 1/4 of dose at 8:00 a.m.; 1/4 of dose at 6:00 p.m. and 1/2 of dose at 11:00 p.m. each day for 14 consecutive days, followed by a 7-day rest period. RESULTS: All 27 patients enrolled onto the study were assessable for toxicity. The most common toxicities during the first two cycles of chemotherapy were fatigue, diarrhoea and hand foot syndrome (HFS). Only one out of the nine patients treated at capecitabine dose of 2,750 mg/m(2 )met protocol-specified DLT criteria (fatigue grade 4). However, at these doses the majority of cycles of therapy were delivered without dose reduction or delay. No other episodes of DLT were observed at the same dose steps and at the lower dose steps of capecitabine (1,500/1,750/2,000/2,250/2,500 mg/m(2)). The dose of 2,750 mg/m(2 )is recommended for further study. Tumor responses were observed in patients with metastatic breast and colorectal cancer. CONCLUSION: High doses of chronomodulated capecitabine can be administered with acceptable toxicity. The evidence of antitumor activity deserves further investigation in phase II combination chemotherapy studies